The association of neurocognitive decline and other variables with return to work, hobbies, and activities of daily living after coronary artery bypass graft surgery

Purpose: Coronary artery bypass graft (CABG) surgery is an integral method of palliative treatment for coronary artery disease. Despite many advances in surgical techniques, some patients continue to have neurocognitive deficits after surgery. The impact of these deficits on the patient's ability to return to work (RTW), daily activities of life, and hobbies has not been evaluated fully. The goal of this research project is to describe variables associated with the patients' ability to RTW and necessary and essential activities. Methods: Sixty-three subjects who had CABG surgery with cardiopulmonary bypass (CPB) and who participated in neurocognitive testing preoperatively and postoperatively were interviewed by telephone 7-8 years after CABG surgery. Information was obtained on functional status measured by the Nottingham Health Profile (NHP), symptoms of depression measured by the Center for Epidemiological Studies Depression Scale, RTW status, and ability to participate in hobbies and activities of daily living (ADL) after CABG surgery. Bivariate and multivariate analyses were used to describe the relationship of neurocognitive, clinical, and social variables to RTW, hobbies, and ADL. Results: The ability to return to hobbies and ADL did not vary between individuals who experienced neurocognitive decline and those who did not (p=0.755). Age and presence of angina were significantly associated with difficulty in returning to work (p=0.009, p=0.042). Higher scores on the Center for Epidemiological Studies Depression Scale after surgery were significantly associated with higher NHP scores (p=0.000) and presence of shortness of breath (p=0.000). Presence of angina (p=0.035) was significantly associated with higher scores on the NHP. Conclusions: The relationship of neurocognitive decline after CABG surgery with RTW and activities remains unclear. Studies with larger sample size will further elucidate these relationships.